| NPI | 1235585928 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: SD 15335) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CT 65299) |
| Enumeration Date | 2016-05-11 |
| Last Update Date | 2024-07-15 |